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ELECTRICAL (PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> PROJECT ADDRESS <br /> yb"."cLg�-Y�- 1( Eve�`e <br /> Owner Mail Address City State/Zip Phone <br /> Fj o''v-0 3(,"A EyQretfi w 6- <br /> Tenant )) Mail Address City State/Zip Phone <br /> c � M l �- I L Lie 3 �,.r c�S�i'��r 'S � 4yV-k- \rV f ' <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> CSL <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Us16 of Building Contract Price of Work <br /> 5-Ox TT c Li 3i—W 6 I <br /> Square Footage(If residential new construction, remodel or addition) C tno act Person/Contact Number/Email <br /> Number of devices (If low voltage) VL <br /> C� <br /> Description of Work to Be Done: l��S l f �S �'✓� ��ecti� `yU''►^��) wy�w S <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify that 1 have read and examined this application and know the same to be true and <br /> correct. All provisions of laws and ordinances governing this type of work will be completed <br /> whether specified herein or not. The granting of a permit does not presume to give authority to PERMIT# <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construction. That 1 am authorized by the owner of this property to perform the b <br /> work faK which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> !late <br /> Z Z 76f-j` <br /> Si ure <br /> REVISED 06/06/20M <br />